Report examines how social, economic factors contribute to health disparities in Alameda County

Higher rates of illness among low-income individuals and people of color in Alameda County, Calif., can be attributed to social, economic, transportation, housing, education and other inequalities, according to a report released on Thursday by the Alameda County Public Health Department, the Oakland Tribune reports.

The report, titled "Life and Death From Unnatural Causes in Alameda County," is a local perspective similar to a recent four-part PBS documentary that explored health care inequalities. The report, which summarizes a larger study expected to be released in May, examines 45 years of death certificates and other vital statistics in Alameda County (Hill, Oakland Tribune, 4/17).

The report details health disparities by neighborhood, income and race. For instance, the report found that both blacks and whites living in the Oakland flatlands area have lower life expectancies than residents of the Oakland hills area, although blacks in both areas have the lowest life expectancies overall. Blacks in the Oakland flatlands have an average life expectancy of 70.5 years, compared with 76.6 years for whites, the report found. In Oakland hills, blacks have an average life expectancy of 77.4 years, compared with 82.3 years for whites. According to Sandra Witt, deputy director of public health for the county, residents living in the hills have higher incomes and education, better housing and are more likely to have health insurance. They also have better access to healthy foods and parks, which "adds up to greater opportunities and better health," she said. The report also correlates higher disease and deaths with the lowest-income parts of the county -- including parts of North Oakland, West Oakland and East Oakland -- which are largely populated by blacks and Hispanics (Fernandez, San Francisco Chronicle, 4/18).

Tony Iton, the county public health director, said, "This is not your typical health report," adding, "For one thing, it has almost nothing to do with medical care. Instead, this is about housing, about education, employment and how these things are inextricably linked to health." Iton continued, "We're not talking about murder or crime in these statistics. We're also not talking about individual behavior, such as smoking or drug use. In addition, it's not whether you have health insurance or not. It goes deeper than that, to your education level, income level and what your neighborhood is like." Iton said working long hours to pay for rent, living near a lot of liquor stores and fast-food restaurants, exposure to diesel fumes, and lack of access to healthy food options and recreational activities also impact overall health (Oakland Tribune, 4/17). Poverty, racism and discrimination also have a physical impact on health, he added.

Iton called for "sweeping 'structural' policy" reform to address the disparities. He said, "Typically, we in government work in silos. Health people do health policy, education people do their thing, the transportation people do their thing." Iton added, "We can't continue to do this. We have to come together to target the root causes of these disparities" (San Francisco Chronicle, 4/18).

The report is available online (.pdf).